Department of Cardiovascular Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy.
Rev Cardiovasc Med. 2022 Jan 25;23(2):43. doi: 10.31083/j.rcm2302043.
Despite continuous technological developments, transvenous pacemakers (PM) are still associated with significant immediate and long-term complications, mostly lead or pocket-related. Recent technological advances brought to the introduction in clinical practice of leadless PM for selected cohort of patients. These miniaturize devices are implanted through the femoral vein and advanced to the right ventricle, without leaving leads in place. Lack of upper extremity vascular access and/or high infective risk in patients requiring VVI pacing are the most common indications to leadless PM. The recently introduced MICRA AV leadless PM also allows ventricular synchronization through mechanical sensing of atrial contraction waves, thus solving the problem of AV synchronization. This review will discuss and summarize available clinical evidence on leadless PM, their performance compared to transvenous devices, current applications and future perspectives.
尽管不断有技术发展，但经静脉起搏器（PM）仍然与重大的即刻和长期并发症相关，主要与导线或囊袋相关。最近的技术进步使得无导线 PM 在特定患者群体中引入临床实践。这些微型设备通过股静脉植入，并推进到右心室，而不会留下导线。上肢血管通路不足和/或需要 VVI 起搏的患者感染风险高是无导线 PM 的最常见适应证。最近推出的 MICRA AV 无导线 PM 还可以通过机械感知心房收缩波来实现心室同步，从而解决 AV 同步问题。本综述将讨论并总结无导线 PM 的现有临床证据，比较其与经静脉设备的性能、当前的应用和未来的前景。
